tbuckley/cabot-search huggingface dataset:
Medical Migration and the Physician Workforce
Authors: Fitzhugh Mullan
Journal: JAMA (1995)

<h3>Objective.</h3> —Because of the size and growth of the international medical graduate (IMG) contribution to graduate medical education (GME) in the United States, and subsequently to the US physician workforce, it is essential to understand the demographics and patterns of IMG training and practice as well as the routes of entry into the United States. <h3>Data Sources.</h3> —Published data from the American Medical Association, the American Osteopathic Association, and the Association of American Medical Colleges; tabular runs of county-level data contained on the Bureau of Health Professions' Area Resource File. <h3>Results.</h3> —The majority of IMGs who participate in GME in the United States ultimately enter US practices. A significant proportion of exchange visitors eventually enter into permanent practice in the United States, contrary to the intent of the J-1 visa—based GME training as an international educational exchange program. International medical graduates gravitate toward initial residency programs in internal medicine and pediatrics, many of which have unfilled positions; however, IMGs subspecialize at a disproportionately high rate, reducing their net contribution to the generalist pool. Patterns of ultimate practice location of IMGs parallel the patterns of US medical graduates (USMGs). <h3>Conclusions.</h3> —In recent years, participation of IMGs in GME and practice has increased significantly. Most IMGs in GME are not exchange visitors, but are either permanent residents or US citizens. Patterns of specialization and location of IMGs ultimately mirror those of USMGs. National IMG policy must be examined in light of the projected surplus of physicians in the United States. The best option for long-term control of the number of physicians in practice, USMG or IMG, is a system of specifying the number of GME positions nationally. (<i>JAMA</i>. 1995;273:1521-1527)
Certolizumab use in pregnancy
Authors: A Oussalah, M-A Bigard, L Peyrin-Biroulet
Journal: Gut (2009)

<b>1159</b> <h3><b>Objectives:</b></h3> The adenosine monophosphate-activated protein kinase (AMPK) is a central regulator of energy homeostasis and has been considered to be an important therapeutic target for metabolic diseases including diabetes and obesity. AMPK activation induces insulin-independent skeletal muscle glucose uptake by increasing the translocation of Glut4 to the plasma membrane of myocytes. The aim of this study was to evaluate the<sup>18</sup>F-FDG uptake in skeletal muscles in rats treated with Pan-AMPK activator MK-8722. <h3><b>Methods:</b></h3> Male 8 week-old Sprague Dawley rats were randomly assigned to vehicle and MK-8722 (0.3, 1, or 5 mg/kg) treatment groups (n=8 each group). Rats were fasted for 4 hours and treated 30 min before the <sup>18</sup>F-FDG scan. Each rat was scanned two times: at baseline (treated with vehicle) and one week later (treated with vehicle or MK-8772). For each scan, PET data were collected for 100 minutes following IV administration of ~1 mCi <sup>18</sup>F-FDG. Blood glucose levels were measured before and after treatment and during the PET scan. Dynamic PET images were reconstructed using a Maximum a-Priori (MAP) algorithm. Regions of interest (ROIs) were drawn on forelimb skeletal muscles, and average ROI values were calculated in units of standard uptake value (SUV). Group results are reported as: Average SUV ± SEM. <h3><b>Results:</b></h3> For the vehicle group, <sup>18</sup>F-FDG uptake in forelimb skeletal muscle was similar between baseline (0.53 ± 0.03) and retest (0.48 ± 0.02). For the 1 and 5 mg/kg groups, significant increases were observed after treatment (1 mg/kg: 0.53 ± 0.03 vs 0.72 ± 0.05, p &lt; 0.003; 5 mg/kg: 0.52 ± 0.02 vs 1.44 ± 0.03, p &lt; 0.001), while for the 0.3 mg/kg group there was not a significant change (0.55 ± 0.02 vs 0.57 ± 0.04). The blood glucose levels were lower in rats of 1 and 5 mg/kg groups after treatment and that change was not seen in the 0.3 mg/kg groups or the vehicle group following treatment. <h3><b>Conclusion:</b></h3> The study demonstrated that MK-8722 increases <sup>18</sup>F-FDG uptake in skeletal muscles and lowers the blood glucose in rats, which are consistent with its mechanism of action. <sup>18</sup>F-FDG PET could be used to imaging AMPK activation for preclinical and potentially for clinical studies.
Treatment of Cystinuria
Authors: C. E. Dent, M. Friedman, H. Green, L. C. A. Watson
Journal: BMJ (1965)

X-ray films are reproduced in Figs.la-le and 2a-2c (Special Plate) of the two patients (Cases 1 and 2) who show the most convincing stone-dissolution under treatment.We think that 4A3
Oral Cobalamin for Pernicious Anemia
Authors: Frank A. Lederle
Journal: JAMA (1991)

THE TREATMENT of pernicious anemia with cobalamin is one of medicine's great success stories. However, the usual practice of giving the drug as an intramuscular injection has several drawbacks. Injections can be painful, difficult to provide for some patients who are elderly or living alone,<sup>1</sup>and costly if given by health professionals.<sup>2</sup>It is therefore not surprising that the search for an oral preparation began soon after cobalamin was isolated and introduced for parenteral use in 1948. Preparations containing oral intrinsic factor were tried, but antibody production caused some patients to become refractory and relapse.<sup>3</sup>Other studies revealed that a small but constant proportion of an oral dose of cyanocobalamin was absorbed without intrinsic factor, so that by sufficiently increasing the dose, adequate absorption could be attained.<sup>4,5</sup> Promising results from early studies of oral cyanocobalamin therapy led to the use of increasingly larger doses, and several
On Pleuritic Effusion
Authors: J. R. Wardell
Journal: BMJ (1874)

affected, and did not become implicated afterwards, excepting by direct structural continuity with the focus of the disease.Secondly, the absence of any tendency towards suppuration, sloughing, or gangrene was remarkable.There was no loss of tissue up to the time of deathl; vesicationi had occurred on the surface of the growth, but the part was still covered with epithelium.There was venous turgescence in all the iinfiltrated tissucs, as indicated by the dark colour which they assumed; but microscopic examination did not indicate any marked vascularity, such as would have been the case if the develop- ment of new vessels had progressed paripassu with the growth of the disease.The original tissues became more and more swollen by a pro- cess of infiltration ; but the inew product did niot maniifest any tendency
Occupational Hazards for Operating Room-Based Physicians
Authors: Alastair A. Spence
Journal: JAMA (1977)

Comparative analysis of data from three large retrospective surveys in the United States and the United Kingdom reaffirms an increased incidence of spontaneous abortion among female physicians working in the operating room. The live-born children of female physicians exposed in the operating room also had substantially more congenital abnormalities. Male anesthetists, compared with nonanesthetist physicians, had an increased incidence of hepatic disease; there was also an increased frequency of congenital abnormality in their children. The incidence of spontaneous abortion in wives of male anesthetists and in the rate of cancer among exposed male anesthetists was similar to control. Despite differences in survey methods and analysis, there was remarkable agreement in conclusions to be drawn from the independent studies. (<i>JAMA</i>238:955-959, 1977)
Book: The Arts in Healthcare: Learning from Experience
Authors: J. Beadle
Journal: BMJ (2000)

Eds Duncan Haldane, Susan Loppert King's Fund Publishing, £14.99, pp 164 ISBN 1 85717 246 9 Rating: ![Graphic][1]</img>![Graphic][2]</img> Siting the arts in the public domain is often a contested practice. The specific and particular demands of the healthcare environment make this no exception. This publication of presentations delivered to the conference “Arts in Healthcare,” held at the Roehampton Institute in September 1997, follows other attempts to collate and validate the expansive and constantly diverging practices that occur under the generic term “arts in health care.” As Duncan Haldane acknowledges in his introduction, one of the recurring issues in any debate on the arts in health care is that of how such projects might be … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif
Cytomegalovirus Encephalitis in Immunologically Normal Adults
Authors: C. Alan Phillips
Journal: JAMA (1977)

Acute cytomegalovirus (CMV) encephalitis developed in two immunologically normal adults. The diagnosis was confirmed by isolation of CMV from the CSF and urine in one case and from temporal lobe biopsy tissue, CSF, and urine in the second case. Both patients were treated with vidarabine and showed dramatic clinical improvement. Virus excretion, which had been chronic in one case, cleared after therapy. To our knowledge, these are the first persons with CMV encephalitis evidenced by isolation of the virus from the CNS. The response to vidarabine was impressive and warrants further evaluation. (<i>JAMA</i>238:2299-2300, 1977)
Cytomegalovirus Infection
Authors: Wing Chin
Journal: JAMA (1973)

In the adult, involvement of the central nervous system in association with cytomegalovirus infection is apparently rare. We recently treated a 31-year-old man who had meningoencephalitis and documented cytomegalovirus infection. We do not know whether the central nervous system symptoms were due to actual invasion of brain tissue by the virus or whether the brain injury was the result of an immunologic process.
The Second Baby Doe Rule
Authors: Loretta M. Kopelman
Journal: JAMA (1988)

<h3>To the Editor.</h3> —In an otherwise interesting article, Fischer and Stevenson<sup>1</sup>mistakenly indicate that the "Baby Doe" regulations are no longer in effect: "Before being struck down, the 'Baby Doe' rule generated intense debate." Several sets of regulations received this name because they were inspired by the same legal case and because they say much the same thing. The Supreme Court<sup>2</sup>rejected earlier Baby Doe regulations (BDR-I) promulgated by the Reagan administration using Section 504 of the Rehabilitation Act of 1973.<sup>3</sup>Section 504 is a portion of the civil rights law that states must follow. This ruling about BDR-I, however, does not affect the current Baby Doe regulations (BDR-II) because they have a different basis in the law. The BDR-II are based on the 1984 amendments to the Child Abuse Prevention and Treatment Act.<sup>4</sup>They have not yet been tested by the courts. The BDR-II are
Effects of Burns on the Heart
Authors: Vijay V. Joshi
Journal: JAMA (1970)

Analysis of clinicopathological data of seven fatal cases of burned children showed that congestive heart-failure was a major factor in their deaths. The possibility of an overload of fluid administered intravenously was ruled out. No detailed account of cases of this type was found in the literature. The patients had infected burns, prolonged clinical course, anemia, episodes of hypokalemia and hyperkalemia, systemic hypertension, and hypoproteinemia. At autopsy, all cases showed cardiomegaly with focal inflammatory and degenerative lesions of the myocardium. There is a possible relationship of the above factors and myocardial lesions to congestive heart-failure. Physicians should be alert to the possibility of congestive heart-failure in burned children.
Furosemide Compared With Hydrochlorothiazide
Authors: Matthew A. Araoye
Journal: JAMA (1978)

In a double-blind crossover study, the effectiveness of furosemide, 40 mg twice daily, was compared with hydrochlorothiazide, 50 mg twice daily, in hypertensive patients. Both hydrochlorothiazide and furosemide significantly reduced blood pressure (BP) during three months of therapy. However, the fall in BP was consistently greater with hydrochlorothiazide than with furosemide, although the difference was significant only with respect to systolic BP. The somewhat greater antihypertensive effectiveness of hydrochlorothiazide may be related to its longer action permitting a more continuous diuretic effect and, hence, maintenance of reduced extracellular fluid volume throughout the 24-hour period. (<i>JAMA</i>240:1863-1866, 1978)
High-Density—Lipoprotein Cholesterol in Bodybuilders v Powerlifters
Authors: Ben F. Hurley
Journal: JAMA (1984)

To determine the relationship between lipid profiles and the type of weight training and to assess the effects of anabolic-androgenic steroids on lipids, bodybuilders and powerlifters of similar age, body fat, and testosterone levels were studied before and after androgen use. Before androgen administration powerlifters had lower levels of plasma high-density—lipoprotein cholesterol (HDL-C) and HDL<sub>2</sub>-C (38±2; 6±1 mg/dL; X ± SE, n=8) than bodybuilders (55 ±2; 12 ± 1 mg/dL; n=8) and runners of comparable age and body fat (47 ±2; 14±2 mg/dL; n=8), while levels of low-density—lipoprotein cholesterol (LDL-C) were higher in powerlifters 138±10 mg/dL) than in bodybuilders (104±7 mg/dL) and runners (110 ±6 mg/dL). Therefore, powerlifters had higher LDL-C/HDL-C ratios (3.7 ±0.3) than bodybuilders (2.0 ±0.2) and runners (2.4 ±0.2). Androgen use by eight bodybuilders and four powerlifters lowered values of both HDL-C and HDL<sub>2</sub>-C by 55% and raised values of LDL-C (61% ±10%) and LDL-C/HDL-C ratios (280%±40%). Therefore, the training regimen of bodybuilders is associated with a more favorable lipid profile than the training used by powerlifters. Androgen use by strength-trained athletes may increase their risk for coronary heart disease. (<i>JAMA</i>1984;252:507-513)
Human Umbilical Cord
Authors: Herbert Dardik
Journal: JAMA (1976)

Reconstructions were performed to the popliteal, tibial, and peroneal arteries employing a modified umbilical cord vein prosthesis. The latter was obtained from human cords and was made available as an onshelf graft for surgery following glutaraldehyde tanning. The early patency and limb salvage rates are equivalent to those obtained with autogenous saphenous veins. Additional benefits include significant decreased operative time and morbidity. It is also probable that this new graft may be resistant to biodegradation and therefore may obviate many of the causes for late failure that occur with the use of living biologic tissues or collagen tubes. Long-term follow-up and study are essential to validate the results obtained thus far and to assess the potential of this new graft in a variety of vascular reconstructions. (<i>JAMA</i>236:2859-2862, 1976)
Pathoanatomic, Pathophysiologic and Clinical Correlations in Endocarditis
Authors: Howard L. Bleich, Emily S. Boro, Louis Weinstein, Jacob J. Schlesinger
Journal: New England Journal of Medicine (1974)

EmbolizationExcept for congestive heart failure, arterial emboli are the most frequent complications of infective endocarditis. The clinically detected incidence of these emboli has decreased from between 70 and 97 per cent before antibiotic therapy to between 15 and 35 per cent at present 40, 50 51 52 53 The most common sites are the coronary vessels, spleen, kidneys and brain. Splenic emboli have been discovered at autopsy in 44 per cent of cases but are rarely detected clinically. Renal infarcts have been found in as many as 56 per cent of fatal cases40 but are clinically recognized less often. Myocardial infarction, often undetected by . . .
Cardioprotective efficacy of limb remote ischaemic preconditioning in rats: discrepancy between a meta-analysis and a three-centre <i>in vivo</i> study
Authors: Nabil V Sayour, Gábor B Brenner, András Makkos, Bernadett Kiss, Csenger Kovácsházi, Tamás G Gergely, Sverre Groever Aukrust, Huimin Tian, Viktória Zenkl, Kamilla Gömöri, Tamara Szabados, Péter Bencsik, Andre Heinen, Rainer Schulz, Gary F Baxter, Coert J Zuurbier, Zoltán Vokó, Péter Ferdinandy, Zoltán Giricz
Journal: Cardiovascular Research (2023)

Abstract Aims Remote ischaemic preconditioning (RIPC) is a robust cardioprotective intervention in preclinical studies. To establish a working and efficacious RIPC protocol in our laboratories, we performed randomized, blinded in vivo studies in three study centres in rats, with various RIPC protocols. To verify that our experimental settings are in good alignment with in vivo rat studies showing cardioprotection by limb RIPC, we performed a systematic review and meta-analysis. In addition, we investigated the importance of different study parameters. Methods and results Male Wistar rats were subjected to 20–45 min cardiac ischaemia followed by 120 min reperfusion with or without preceding RIPC by 3 or 4 × 5−5 min occlusion/reperfusion of one or two femoral vessels by clamping, tourniquet, or pressure cuff. RIPC did not reduce infarct size (IS), microvascular obstruction, or arrhythmias at any study centres. Systematic review and meta-analysis focusing on in vivo rat models of myocardial ischaemia/reperfusion injury with limb RIPC showed that RIPC reduces IS by 21.28% on average. In addition, the systematic review showed methodological heterogeneity and insufficient reporting of study parameters in a high proportion of studies. Conclusion We report for the first time the lack of cardioprotection by RIPC in rats, assessed in individually randomized, blinded in vivo studies, involving three study centres, using different RIPC protocols. These results are in discrepancy with the meta-analysis of similar in vivo rat studies; however, no specific methodological reason could be identified by the systematic review, probably due to the overall insufficient reporting of several study parameters that did not improve over the past two decades. These results urge for publication of more well-designed and well-reported studies, irrespective of the outcome, which are required for preclinical reproducibility, and the development of clinically translatable cardioprotective interventions.
Heparin Necrosis
Authors: John C. Hall
Journal: JAMA (1980)

Lesions indistinguishable from coumarin necrosis developed in three patients who were given heparin sodium subcutaneously. Two of the patients had received only heparin while another had also received coumarin. Heparin necrosis should be added to the list of complications of anticoagulation therapy. (<i>JAMA</i>244:1831-1832, 1980)
Metyrapone Test With Adrenocorticotrophic Levels
Authors: Loren I. Dolman
Journal: JAMA (1979)

Basal plasma adrenocorticotrophic hormone (ACTH) and cortisol concentrations as well as plasma ACTH and 11-deoxycortisol responses to the administration of a single dose of metyrapone were evaluated in 104 patients with intact pituitary-adrenal axis, in 20 patients with secondary adrenal insufficiency, and in seven patients with primary adrenal insufficiency. In patients with primary adrenal insufficiency, baseline ACTH levels were high. Following metyrapone administration, 11-deoxycortisol concentrations were low and ACTH levels did not change. In patients with secondary adrenal insufficiency, baseline plasma ACTH levels were normal, but neither 11-deoxycortisol nor ACTH levels increased in response to metyrapone. The metyrapone test is not only useful to screen for adrenal insufficiency, it is also useful to differentiate a primary from a secondary cause. (<i>JAMA</i>241:1251-1253, 1979)
Plasticity and Stereotypic Rewiring of the Transcriptome Upon Bacterial Evolution of Antibiotic Resistance
Authors: Gábor Grézal, Réka Spohn, Orsolya Méhi, Anett Dunai, Viktória Lázár, Balázs Bálint, István Nagy, Csaba Pál, Balázs Papp
Journal: Molecular Biology and Evolution (2023)

Abstract Bacterial evolution of antibiotic resistance frequently has deleterious side effects on microbial growth, virulence, and susceptibility to other antimicrobial agents. However, it is unclear how these trade-offs could be utilized for manipulating antibiotic resistance in the clinic, not least because the underlying molecular mechanisms are poorly understood. Using laboratory evolution, we demonstrate that clinically relevant resistance mutations in Escherichia coli constitutively rewire a large fraction of the transcriptome in a repeatable and stereotypic manner. Strikingly, lineages adapted to functionally distinct antibiotics and having no resistance mutations in common show a wide range of parallel gene expression changes that alter oxidative stress response, iron homeostasis, and the composition of the bacterial outer membrane and cell surface. These common physiological alterations are associated with changes in cell morphology and enhanced sensitivity to antimicrobial peptides. Finally, the constitutive transcriptomic changes induced by resistance mutations are largely distinct from those induced by antibiotic stresses in the wild type. This indicates a limited role for genetic assimilation of the induced antibiotic stress response during resistance evolution. Our work suggests that diverse resistance mutations converge on similar global transcriptomic states that shape genetic susceptibility to antimicrobial compounds.
Deciphering the Genetic Basis of Silkworm Cocoon Colors Provides New Insights into Biological Coloration and Phenotypic Diversification
Authors: Yaru Lu, Jiangwen Luo, Erxia An, Bo Lu, Yinqiu Wei, Xiang Chen, Kunpeng Lu, Shubo Liang, Hai Hu, Minjin Han, Songzhen He, Jianghong Shen, Dongyang Guo, Nvping Bu, Ling Yang, Wenya Xu, Cheng Lu, Zhonghuai Xiang, Xiaoling Tong, Fangyin Dai
Journal: Molecular Biology and Evolution (2023)

Abstract The genetic basis of phenotypic variation is a long-standing concern of evolutionary biology. Coloration has proven to be a visual, easily quantifiable, and highly tractable system for genetic analysis and is an ever-evolving focus of biological research. Compared with the homogenized brown-yellow cocoons of wild silkworms, the cocoons of domestic silkworms are spectacularly diverse in color, such as white, green, and yellow-red; this provides an outstanding model for exploring the phenotypic diversification and biological coloration. Herein, the molecular mechanism underlying silkworm green cocoon formation was investigated, which was not fully understood. We demonstrated that five of the seven members of a sugar transporter gene cluster were specifically duplicated in the Bombycidae and evolved new spatial expression patterns predominantly expressed in silk glands, accompanying complementary temporal expression; they synergistically facilitate the uptake of flavonoids, thus determining the green cocoon. Subsequently, polymorphic cocoon coloring landscape involving multiple loci and the evolution of cocoon color from wild to domestic silkworms were analyzed based on the pan-genome sequencing data. It was found that cocoon coloration involved epistatic interaction between loci; all the identified cocoon color-related loci existed in wild silkworms; the genetic segregation, recombination, and variation of these loci shaped the multicolored cocoons of domestic silkworms. This study revealed a new mechanism for flavonoids-based biological coloration that highlights the crucial role of gene duplication followed by functional diversification in acquiring new genetic functions; furthermore, the results in this work provide insight into phenotypic innovation during domestication.